Hemiplegic Migraine Induced by Exertion

Razavi, Mehrdad; Razavi, Behzad; Fattal, Deema; Afifi, Adel K.; Adams, Harold P.

doi:10.1001/archneur.57.9.1363

Cited by 24 publications

(23 citation statements)

References 16 publications

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“…1 However, patients with similar clinical symptoms but without other affected family members have been reported, 2-13 and the term sporadic hemiplegic migraine (SHM) has been used. 2,7,9,11,12 Currently, these patients are classified as having migraine with typical aura (MA) or migraine with prolonged aura according to the classification of the International Headache Society (IHS classification).We examined the similarity of the clinical characteristics of SHM to those of MA and those of FHM by comparing SHM with our data on FHM 14 and with a historical group of patients with MA. 15 Materials and methods.…”

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confidence: 99%

“…1 However, patients with similar clinical symptoms but without other affected family members have been reported, [2][3][4][5][6][7][8][9][10][11][12][13] and the term sporadic hemiplegic migraine (SHM) has been used. 2,7,9,11,12 Currently, these patients are classified as having migraine with typical aura (MA) or migraine with prolonged aura according to the classification of the International Headache Society (IHS classification).…”

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confidence: 99%

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Evidence for a separate type of migraine with aura

Thomsen¹,

Østergaard²,

Olesen³

et al. 2003

Neurology

116

103

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confidence: 99%

mentioning

confidence: 99%

Evidence for a separate type of migraine with aura

Thomsen¹,

Østergaard²,

Olesen³

et al. 2003

Neurology

116

103

View full text Add to dashboard Cite

show abstract

“…There are anecdotal reports of episodes of migraine preceded by head trauma and visual symptoms (with a past history of non-sports-related migraine) [6], migraine prodrome symptoms after unusually strenuous running with no subsequent head pain [7] or recurrent attacks of hemiplegic migraine induced only by exertion [8]. …”

Section: Discussionmentioning

confidence: 99%

“…In our patients, exertion seems to precipitate the aura. It has been suggested that the combination of exertion-induced hyperventilation and the subsequent hypocapnia with respiratory alkalosis and hypomagnesemia predisposes these patients to cerebral vasoconstriction during exertion lowering the threshold for the development of CSD or aura in migraineurs [8]. …”

Section: Discussionmentioning

confidence: 99%

Migraine with aura in the locker room: three case reports

et al. 2011

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It is well known that physical activity can aggravate the intensity of the headache, but the pathophysiological relationship between exertion and aura is still unknown. Anecdotal reports describe episodes of migraine preceded by head trauma and visual symptoms, migraine prodrome symptoms after unusually strenuous running with no subsequent head pain or recurrent attacks of hemiplegic migraine induced only by exertion. We describe the cases of three young men with recurrent episodes of migraine with aura occurring in the locker room shortly after a football match. Since the symptoms could mimic important pathologies in approximately 10% of these of headaches, it was mandatory to exclude a secondary form of headache in these patients. Several theories exist regarding the cause of primary exertional headache, but the pathogenesis of migraine triggered by physical activity has still not been identified. The present International Classification of Headache Disorders does not mention sport/exercise-induced migraine with aura episodes as primary headache. Since there are many cases described in the literature of migraine with aura triggered only by exercise, it may be helpful to specify, in the typical aura with migraine headache comments, that in some cases it can be exclusively triggered by sport/exercise.

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“…Four patients with SHM were administered 120 mg verapamil orally from once to three times daily and experienced a significant reduction of attack frequency 81,104 . Furthermore, a female with exertion‐induced SHM enjoyed remission taking verapamil 105 . Following these reports, I used verapamil in several FHM/SHM patients without marked efficacy (A. Ducros, personal data).…”

Section: Preventive Agentsmentioning

confidence: 99%

Hemiplegic Migraine: Clinical Features, Links with Basilar-type Migraine, Current and Future Treatment

Ducros

2006

Headache Currents

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Hemiplegic migraine (HM) is a rare variety of migraine with aura characterized by the presence of a motor weakness during the aura. The HM has two main forms according to the familial history: cases where at least one first-or second-degree relative has aura including motor weakness have familial hemiplegic migraine (FHM), and cases without such familial history have sporadic hemiplegic migraine (SHM). FHM is the only variety of autosomal dominant migraine and all three known genes encode ion-transporters. Typical HM attacks include a motor weakness that is always associated to other aura symptoms, the most frequent being sensory, visual, and speech disturbances. In addition, basilar-type symptoms occur in up to 70% of the patients. Severe attacks may occur in FHM as well as in SHM with prolonged hemiplegia, confusion, coma, fever, and seizures. The clinical spectrum also includes permanent cerebellar signs (nystagmus, ataxia, dysarthria) and less frequently various types of seizures and mental retardation. A genetic diagnosis is now possible by screening the two major genes involved in FHM (CACNA1A and ATP1A2). Treatment of FHM and SHM is based on what is done in other varieties of migraine with aura. According to the new physiopathologic insights, preventive treatments by various antiepileptic agents seem promising.

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Hemiplegic Migraine Induced by Exertion

Abstract: Migraine aura should be included in the differential diagnosis of exertion-induced focal neurologic deficit.

Cited by 24 publications

References 16 publications

Evidence for a separate type of migraine with aura

Evidence for a separate type of migraine with aura

Migraine with aura in the locker room: three case reports

Hemiplegic Migraine: Clinical Features, Links with Basilar-type Migraine, Current and Future Treatment

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